A small vesicovaginal fistula (<1 cm) is detected 10 days after total abdominal hysterectomy. The initial recommended management is:
- A Continuous bladder drainage with an indwelling catheter for 4-6 weeks ✓
- B Immediate surgical repair
- C Fulguration of the fistula tract
- D Latzko partial colpocleisis
Correct answer: A. Continuous bladder drainage with an indwelling catheter for 4-6 weeks
Explanation
Small, uncomplicated vesicovaginal fistulas detected early (within 7-14 days of surgery) may heal with continuous bladder drainage via an indwelling Foley catheter for 4-6 weeks. This allows the bladder to remain decompressed and the fistula to close spontaneously. Immediate repair is avoided due to inflamed, edematous tissues. Fulguration may be used for a small residual tract. Latzko procedure is for recurrent or complex fistulas.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.